Does haemostatic therapy improve the prognosis in upper gastrointestinal bleeding?

Area of Science:

• Gastroenterology
• Endoscopic interventions
• Hemorrhagic ulcer treatment

Background:

• Peptic ulcer hemorrhage poses significant clinical challenges.
• Traditional management often involves invasive surgical procedures.
• Evaluating novel therapeutic approaches is crucial for improving patient outcomes.

Purpose of the Study:

• To compare the outcomes of peptic ulcer hemorrhage before and after the implementation of endoscopic therapy.
• To assess the impact of endoscopic therapy on surgical intervention and mortality rates.
• To identify the most effective endoscopic treatment modality.

Main Methods:

• A retrospective and prospective study design involving 816 patients with peptic ulcer hemorrhage.
• A control group of 505 patients treated before endoscopic therapy introduction.
• A prospective group of 311 patients treated after endoscopic therapy introduction, with detailed matching for key clinical variables.

Main Results:

• Endoscopic therapy was associated with reduced rates of surgical intervention and mortality for both gastric and duodenal ulcers.
• The beneficial effect was particularly noted in patients with visible vessels at the ulcer base.
• Adrenaline injection therapy demonstrated simplicity, low cost, and availability, suggesting it as a preferred treatment.

Conclusions:

• Endoscopic therapy offers a significant improvement in outcomes for peptic ulcer hemorrhage.
• Endoscopic injection therapy, specifically adrenaline, is a viable and effective treatment option.
• This approach reduces the need for surgery, particularly in high-risk patients with visible bleeding vessels.